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VA Admits Hepatitis C Service Connection by Jet Guns

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88% of US military veterans with HCV are not treated
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Lack of Standards for
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1970 Jetgun
Nursing Instructions


Dried Hepatitis C Blood Exposure 11/23/2013 Weeks later inconspicuous blood transmits virus and more likely to cause accidental exposures to Hep C
2013 AASLD Study Hepatitis C not an STD
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Plan Backfires-
VBA Fast Letter Boost Claims
Legal- Fed Regs state:
Judge decision may be relied upon
Cotant v. Principi, 17 Vet.App. 116, 134 (2003),

Service Connected Claims
# 1 Conclusion of Law 
# 2 Conclusion of Law 
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Jetgun Decisions
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After the jetgun win
What to do next


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Medical or Dental Procedures & Reused Devices


Blood Typing- Troops stood in line and the lancet was reused till dull.... CDC and the Food and Drug Administration (FDA) have recommended since 1990 that fingerstick devices be restricted to individual use
2004 CDC Report Finger Stick Device Lancets



1970 Jetgun Nursing InstructionsHow to use the jetgun, detailing how the device got contaminated. ____________________________________________________________________________________________
1990 FDA Jetgun Autoclaves RecalledFDA Enforcement Report- Vernitron Majestic Table Top Sterilizers, Models 8080, Recall...The locking hub may detach from the unit at high pressure...compromise of sterility... (note: these autoclaves were used to sterilize the Ped-o-Jet Jetguns used by the military. Sterilization could not be guaranteed.) ____________________________________________________________________________________________
1999 Global InjectionsUnsafe injections in the developing world and transmission of bloodborne pathogens: a review-...Five studies attributed 20-80% of all new infections to unsafe injections...major mode of transmission of hepatitis C... occur routinely ____________________________________________________________________________________________
2003 CDC GuidelinesNosocomial transmission of bloodborne viruses from infected health care workers to patients...some occupations ... higher risk ... rate of HCV in oral surgeons ____________________________________________________________________________________________
2004 CDC Jetgun HistoryResearch by the CDC on jetgun history- Needle-Free Jet Injection Bibliography, Device & Manufacturer Roster, and Patent List ____________________________________________________________________________________________
2004 CDC Report Finger Stick Device LancetsCDC and the Food and Drug Administration (FDA) have recommended since 1990 that fingerstick devices be restricted to individual use ____________________________________________________________________________________________
2005 USA Surgica Tissue Adhesive Hepatitis C scare halts use of surgical adhesive-The Health, Labor and Welfare indistry on Tuesday ordered a pharmaceutical company to stop the sale of an imported surgical tissue adhesive after an elderly man ...contracted the hepatitis C virus ... weakened following an operation...died ____________________________________________________________________________________________
2005 VA Surgical Clinics InvestigationEL PASO, Tx - A Beaumont Army Hospital staff member contracts Hepatitis "c" and now several patients are also infected. Up to 5% of all the patients tested so far have tested positive... ____________________________________________________________________________________________
2008 HCV Dental Implants TransmissionHepatitis patient sues, blames dental implants-A woman who underwent dental implant surgery ...suing the makers of products ... after she learned the products had been recalled and she had contracted Hepatitis C. ____________________________________________________________________________________________
2008 Legal Advice for PatientsPUBLIC HEALTH CRISIS: Queries irk hepatitis patients- Attorneys telling clients not to reveal past drug, sexual activity- Southern Nevada Health District's intent to embarrass...when it determined what questions to ask former patients of two Las Vegas gastroenterology clinics regarding their past risk factors for hepatitis... ____________________________________________________________________________________________
2008 Multi-Risk Transmission FactorsFrequency distribution of hepatitis C virus genotypes in different geographical regions of Pakistan and their possible routes of transmission- Infectious Diseases 2008, 8:69...More than 70% of the cases were acquired in hospitals through reuse of needles/syringes and major/minor surgery... ____________________________________________________________________________________________
2008 NV State Investigation UPDATE So Nevada Hepatitis C Investigation UPDATE:"Patients were put at risk, health officials say, when a syringe would be reused on an infected patient and then used to draw anesthesia from vials intended for just one patient. The vials would then be used on other patients, potentially spreading disease." ____________________________________________________________________________________________
2008 VA Nevada Exposures VA Office of Inspector General,inspectionefurbished scopes were purchased and a scope broke... GI providers reused syringes...contaminated medication from vials...contracts were awarded to the GI provider group or that senior managers received kickbacks. ____________________________________________________________________________________________
2009 CDC Report- Hemodialysis Unit Hepatitis C Virus Transmission at an Outpatient Hemodialysis Unit --- New York, 2001--2008 -...  negative to anti-HCV positive in a New York City hemodialysis unit Supervisory staff members failed to address these breaches. Many of the direct care staff members were unaware of ...unit's written infection control policies, including those pertaining to cleaning and disinfection. Investigators also noted the lack of a separate clean area for... has 8% risk factor ____________________________________________________________________________________________
2009 Congressional Probe - VA ClinicsKerry urges probe of unsanitary conditions at VA __________________________________________________________________________________________________
2009 GA Med Center EndoscopesColumbia County Medical Center In Hot Water-GA officials.. look at a local medical center. Workers... not have followed proper cleaning procedures. ..1,300 patients... received this letter...concerns over the sterilization process of endoscopes ____________________________________________________________________________________________
2009 GA VA Ear, Nose and Throat ClinicThe fact that it took five years for them to catch a mistake like that....nose and throat clinic at the VA Medical Center ...that they may have been exposed... ____________________________________________________________________________________________
2009 TN VA Wrong ValvesVA mum extent of equipment contamination caused by wrong valve used during procedures... noticed wrong valve on the tubing used in colonoscopies ____________________________________________________________________________________________
2009 VA- FL EndoscopesThe VA insists the risk of infection is minimal and only involved tubing on equipment, not any device that actually touched a patient. ____________________________________________________________________________________________
2010 CDC Report- Mulitple ExposuresHCV quasispecies sequences from the patients were nearly identical (96.9%–100%) to those from source patients with chronic viral hepatitis. All affected patients in both clinics received ____________________________________________________________________________________________
2010 Lawsuit Nevada...Health officials have blamed reuse of vials ... jury...ordered Teva ... to pay $356 million in punitive damages..Baxter...$144 million.. ____________________________________________________________________________________________
2013 HCV transmitted by biopsy forcepsThe problem at a colposcopy clinic ...began in May 1999 and was detected on May 24 of this officials are contacting nearly 2,500 patients after discovering that unsterilized biopsy forceps were used ____________________________________________________________________________________________
Dental treatmen was commonest conventional risk factor Dental treatment: 278 (32.55%)...Non-conventional transmission of hepatitis C: a true possibility ignored... show very high risk for HCV transmission by dental procedures. ____________________________________________________________________________________________
Finger Stick DeviceIn teaching patients how to administer finger sticks and insulin shots to themselves, the nurse changed the needle.. but reused...I don't believe this nurse was cognizant of the possibility...was a potential source.. ____________________________________________________________________________________________
HCV Detected in Dental SurgeriesOur data indicate that there is extensive contamination by HCV of dental surgeries after treatment of anti-HCV patients and that if sterilisation and disinfection are inadequate there is the possible risk of transmission to susceptible individuals ญญญญญญญญญญญญญญญญญญญญญญญญญญญญ____________________________________________________________________________________________
VA OIG ReportVA supply orders not equal to demand... __________________________________________________________________________________________________

See this link for section on Jetgun injections aka MUNJI, Air guns

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Revised: May 15, 2015 .